Stress management and factors related to the deployment of Italian peacekeepers in Afghanistan.

This cross-sectional study evaluated the stress levels in Italian military personnel involved in a peacekeeping (PK) mission in Afghanistan and a homogeneous group stationed in Italy (SI group). The study was performed from April 2004 to June 2004 in a sample of 160 long-time, career volunteers of the Rossi Barracks of the Alpini di L'Aquila (Italy) (SI group, n=120; PK group, n=40). A 10-item, self-evaluation questionnaire proposed in the U.N. Stress Management Booklet was administered to each volunteer. The total item score (TIS) values for the 10 items for the two groups were calculated. These values were greater for the PK group than for the SI group for all 10 items. The TIS values were grouped into three classes of symptoms, anxiety symptoms (items 1-4), stress-induced depression (items 5-7), and posttraumatic stress (items 8-10). The class total item score (CTIS) values were then calculated as the sum of the respective TIS values. The three CTIS values for the PK group were greater than those for the SI group. In particular, the anxiety CTIS was 72 points greater in the PK group (p < 0.001). Therefore, the peacekeepers were inclined to have a greater increase in anxiety symptoms. Consequently, antipanic techniques could be used to reduce anxiety and progressive muscular relaxation training, an important preventive relaxation technique, to face stressors and to reduce clinical anxiety.

Platelet gel for healing cutaneous chronic wounds.

Wound healing is a specific host immune response for restoration of tissue integrity. Experimental studies demonstrated an alteration of growth factors activity due to their reduced synthesis, increased degradation and inactivation. In wound healing platelets play an essential role since they are rich of alpha-granules growth factors (platelet derived growth factor--PDGF; transforming growth factor-beta--TGF-beta; vascular endothelial growth factor--VEGF). Topical use of platelet gel (PG), hemocomponent obtained from mix of activated platelets and cryoprecipitate, gives the exogenous and in situ adding of growth factors (GF). The hemocomponents are of autologous or homologous origin. We performed a technique based on: multicomponent apheretic procedure to obtain plasma rich platelet and cryoprecipitate; manual processing in an open system, in sterile environment, for gel activation. Every step of the gel synthesis was checked by a quality control programme. The therapeutic protocol consists of the once-weekly application of PG. Progressive reduction of the wound size, granulation tissue forming, wound bed detersion, regression and absence of infective processes were considered for evaluating clinical response to hemotherapy. 24 patients were enrolled. They had single or multiple cutaneous ulcers with different ethiopathogenesis. Only 3 patients could perform autologous withdrawal; in the others homologous hemocomponent were used, always considering suitability and traceability criteria for transfusional use of blood. Complete response was observed in 9 patients, 2 were subjected to cutaneous graft, 4 stopped treatment, 9 had partial response and are still receiving the treatment. In each case granulation tissue forming increased following to the first PG applications, while complete re-epithelization was obtained later. Pain was reduced in every treated patient. Topical haemotherapy with PG may be considered as an adjuvant treatment of a multidisciplinary process, useful to enhance therapy of cutaneous ulcers.

Burn injury secondary to air bag deployment.

The efficacy of air bags has been proven in diminishing the rate of fatalities and severity of injury in motor vehicle crashes. Unfortunately, as with any developing technology, new problems have been encountered that are directly attributable to the deployment of the air bag itself. Most air bag-related injuries are minor and, surprisingly, more than 7% are burns typically involving the upper extremity or head or neck. Fortunately, these are superficial burns that usually require only expectant therapy, but a high degree of suspicion in these circumstances is needed to make the proper diagnosis.